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Justice with empathy: The rise of mental health courts

Updated: Jan 17

Black male judge holds gavel in right hand and law book in left hand from his bench seat in front of a gold justice scales picture

Note: This post features insights from Mark J. Heyrman Chair, Public Policy Committee

Mental Health America of Illinois, a retired law professor from the University of Chicago and Of Counsel with Monahan Law Group in Chicago, Illinois.

Mental health courts are becoming increasingly common across the country, with a reported 450 currently in operation across 45 states. For those who are unfamiliar with the concept, mental health courts are an alternative to traditional criminal “punishments.” The purpose is to provide individuals who commit misdemeanors and suffer from mental health issues with genuine support and resources to reduce their likelihood of reoffending and improve their lives.

The beginning of mental health courts

The first mental health court was set up in 1997 by an administrative order in Florida. But, as Mark Heyrman explains, usually, mental health courses are started by judges who “see a revolving door and think it’s stupid”. The judges can, “sentence them to short times in jail because most are misdemeanors but then they come back again. It doesn’t do them or the county any good.” 

According to Mark, most of the crimes that lead to an individual being referred to a mental health court are so-called “crimes of survival.” This may be low-level theft, breaking into buildings to escape the cold during winter, or similar misdemeanor crimes.

A favorite approach for sympathetic judges

For judges, this can be frustrating to deal with. Although prosecutors and the person in question can request access to a mental health court, the main movers are generally the judges themselves. Time and again, they see the same individuals returning for similar, low-level offenses. Not only do cases like this waste taxpayer money and court time with little to show for it, but the individuals in question can’t reach their human potential because they don’t have access to the help they need. 

Justice Kathryn Zenoff, the instigator of the first mental health court in Illinois, summarized the problem well. In her official testimony for the “Human Rights at Home: Mental Illness in U.S. Prisons and Jails” hearing, she says:

“In the last fifty years, persons with serious mental illnesses have gone from being institutionalized in psychiatric hospitals to being institutionalized in our jails and prisons. The phenomenon has been called the ‘criminalization of the mentally ill’ and has had adverse consequences both for our communities and for those persons with mental illnesses.”

What impact do the courts have?

The courts being a favorite of many judges around the country speaks in their favor. But why do many judges opt for this approach and are there any tangible benefits?

In Mental Health of America’s official position on mental health courts, there are three clear benefits to mental health courts over more traditional options. 

1. It reduces recidivism among participants

In terms of societal benefit, this is a strong argument in favor of mental health courts. For example, in 2021, 41 states collectively spent over 8 billion dollars to incarcerate 193,000 people for “supervision violations and revocations” – in other words, repeat offenders. One report on the subject found that there has not been enough research done into this subject and drawing conclusions is difficult. However, the report also found that there was a decrease in recidivism compared with traditional criminal processing for mental health courts. 

2. It improves mental health outcomes

On an individual and human level, this approach has also been shown to improve mental health outcomes. One study found that “participation in the mental health court program was associated with longer time without any new criminal charges or new charges for violent crimes.” It also found that completing the program reduced “recidivism and violence after graduates were no longer under supervision of the mental health court.” 

As Mark further points out, after their court-ordered treatment is over, “a huge percentage of [participants] continue to get mental health services if that’s recommended,” showing that the individuals themselves find it useful.

3. It helps avoid or limit incarceration for participants

The lingering effect of misdemeanors can make life particularly difficult for individuals. This could be due to incarceration deteriorating mental health or the societal consequences of having a criminal record. 

As Mark points out, it can be difficult for individuals with a criminal record to find jobs, rent properties, or similar basic necessities. By directing them through a mental health court, they can avoid getting a criminal record if they are first-time offenders and improve their chances of building a positive future for themselves.

White man, a professor, wearing a gold shirt and blue tie addressing his students.
Mark J. Heyrman, J.D.

Problems facing mental health courts

While there is a lot of positivity surrounding mental health courts, there are still areas where we need to improve our approach or dedicate ourselves more to the initiative. 

The motive is important

One point is that the reason behind the mental health courts needs to come from a good place. Mark anecdotally recounts a story of the mental health courts being funded by businesses in a particular area to reduce the number of homeless people on the streets. 

As the businesses paid for this, they had essentially hired a judge for private use to pass judgment with distinct bias. Using mental health courts in this way was found to be unconstitutional and MHAI is firmly against this approach. In general, coercion should be kept to a minimum as much as possible and the outcome of reducing recidivism and improving individual lives should be at the forefront.

Rural areas shouldn’t be forgotten

A quote from the Illinois Criminal Justice Information Authority said, “Courts in rural areas of the state serve smaller populations with a lower prevalence of mental illness, requiring fewer resources to meet their treatment needs.”

Mark disputes the idea that there is a lower prevalence of mental illness in non-urban Chicago, saying, “there is no evidence that there is less mental illness in rural areas – there is less treated mental illness.”

He clarifies by adding, “there is more stigma attached to mental health in rural communities than there is in big cities. My suspicion is that fewer people come forward.” He references the higher rates of suicide in rural areas, which is a strong indicator of mental health challenges.

It needs more funding

Overall, and building on the rural area point, Mark identifies a lack of funding as the main issue mental health courts face. Our criminal justice system shouldn’t simply be a tool to punish individuals in our society, particularly for misdemeanors.

Good judgment is about weighing punishment with a genuine desire to improve the lives of citizens and our society as a whole. By tipping the balance too much in the favor of punishment, we keep the revolving door spinning. Instead, a system built on compassion, support, and constructive approaches to rehabilitation can go a long way to improving our society and individual lives.

To achieve this, we need more dedicated funding. 

Need more information about mental health courts?

If you would like more information about mental health courts and the role they play across Illinois, please feel free to contact us at or (312) 368-9070.


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